Sepsis Treatment in Horses, AAEP 2009

Sepsis is a systemic inflammatory response syndrome (SIRS) in which the whole body is in an inflammatory state due to the presence of a known or suspect bacterial infection. The evolution and future of sepsis treatment in the horse was described by Pamela Wilkins, DVM, PhD, Dipl. ACVIM, ACVECC, at the 2009 American Association of Equine Practitioners (AAEP) convention, held Dec. 5-9 in Las V

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Sepsis is a systemic inflammatory response syndrome (SIRS) in which the whole body is in an inflammatory state due to the presence of a known or suspect bacterial infection. The evolution and future of sepsis treatment in the horse was described by Pamela Wilkins, DVM, PhD, Dipl. ACVIM, ACVECC, at the 2009 American Association of Equine Practitioners (AAEP) convention, held Dec. 5-9 in Las Vegas, Nev.

Severe sepsis can lead to organ dysfunction, low blood pressure, or insufficient blood flow to one or more organs, potentially resulting in septic shock, multiple organ dysfunction, and death. Clinical signs of SIRS include elevated heart and respiratory rates, purplish to muddy-colored mucous membranes, a purplish gingival (gum) line above the teeth, delayed capillary refill time and jugular refill, injected sclera (meaning the sclera of the eyes are peppered with broken blood vessels), and fever or hyperthermia (elevated temperature), potentially leading to hypothermia.

Laboratory data are often telling in sepsis cases. Wilkins remarked that horses with diarrhea and a positive bacterial blood culture are less likely to survive than horses with diarrhea and abnormal coagulation profiles (which check for the blood components that contriubte to clotting). In adult horses with gastrointestinal (GI) disease (colic, or abdominal pain), horses with high blood glucose levels are less likely to survive. If excess blood glucose is spilling into the urine as the kidneys "filter" the blood, attempts at correcting dehydration can be more difficult.

She described bacterial sepsis as a frequent initiator of severe sepsis, particularly in young foals. In neonates, this might be due to failure of passive transfer from colostral antibodies, and/or translocation of bacteria through the bowel wall, rather than having umbilical infection as the primary source. In adult horses sepsis is commonly related to GI disturbances that can lead to diseases such as colic, proximal enteritis (inflammation of the upper GI tract), or colitis (inflammation of the colon)

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Written by:

Nancy S. Loving, DVM, owns Loving Equine Clinic in Boulder, Colorado, and has a special interest in managing the care of sport horses. Her book, All Horse Systems Go, is a comprehensive veterinary care and conditioning resource in full color that covers all facets of horse care. She has also authored the books Go the Distance as a resource for endurance horse owners, Conformation and Performance, and First Aid for Horse and Rider in addition to many veterinary articles for both horse owner and professional audiences.

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